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# SECRETCONTRACT INFORMATION AND CHECK LIST(CONTINUED)*NOTE: SEE INSTRUCTIONS ON FIRST SHEET*NOTE: (See Part XIV of Confidential Fund Regulations or successor regulations-for benefits applicable to various categories of contract personnel. If medical benefits are requested, see R 15-200 or successor regulations.)Missing Persons ActEEC - Annual & sick leaveDeath & Disability benefitFed. IR Retirement ActHome Leave benefitsC.E.N.A Health Ins.SECTION IV| 47. STATUS (Check) | 48. TYPE (Check) || ------------------ | ---------------- || Established        | Complete         |49. IF COVER PAYMENTS ARE CONTEMPLATED, THEY WILL BE EFFECTED ON REIMBURSABLE BASISSECTION V50. OFFSET OF INCOME AND OTHER EMOLUMENTS DERIVED FROM COVER ACTIVITIES (If less than total, justify in separate memo attached hereto.)TOTAL: Partial NoneSECTION VI| 51. DURATION, unspecific | 52. EFFECTIVE DATE | 53. RENEWABLE || ------------------------ | ------------------ | ------------- || 2 months                 | to be negotiated.  | Yes No        |54. TERMINATION NOTICE (Number of days)55. FORFEITURE OF RETURN TRAVEL FOR REPATRIATION PRIOR TO CONTRACT TERMINATIONSECTION VII56. PRIMARY FUNCTION (Pl. Pr. other)PMSECTION VIII57. GENERAL DESCRIPTION OF DUTIES TO BE PERFORMEDDUTIESProvide senior paramilitary support for Agency activitySECTION XIVQUALIFICATIONS58. Retired after 21 years of Army service. Has specialized in special forces operations and had service overseas. From 1956 to present commanded and trained SF tean in Guerrilla Warfare. Was instructor in US Army NCO School for 3 years. 10 Feb.'61 -date CIA contract.| 59. EDUCATION (Check Highest Level Attained) | Grade School               | High School Graduate | Trade School Graduate |     || -------------------------------------------- | -------------------------- | -------------------- | --------------------- | --- || Business School Graduate                     | Commercial School Graduate |                      |                       |     || College (No degree)                          | College Graduate           | MA                   | MS                    | PhD || 60. LANGUAGE COMPETENCY (Check Appropriate Degree Competency) | Language | Speak | Fluent | Average | Poor || ------------------------------------------------------------- | -------- | ----- | ------ | ------- | ---- || German                                                        | X        |       |        |         |      || French                                                        | X        |       |        |         |      || Laotian                                                       | X        |       |        |         |      |62. AREA KNOWLEDGE61. INDIVIDUAL'S COUNTRY OF ORIGINUSASECTION XVPRIOR EMPLOYMENT63. JOB AND SALARY PRIOR TO SERVICE FOR CIAOct.'38 to Oct.'60 US Army. Retired with 21 years service as Captain. Retirement pay $261.00 per monthSECTION XVIADDITIONAL INFORMATION64. ADDITIONAL OR UNUSUAL REQUIREMENTS. JUSTIFICATIONS OR EXPLANATIONS (Use other side if necessary)Hazardous duty pay premium where indicated.APPROVAL| Date        | Typed Name & Signature of Requesting Operating Official | Date      | Approving Official || ----------- | ------------------------------------------------------- | --------- | ------------------ || 10 May 1961 | Ernest F. Fox                                           | 15 may 6/ | Charles J. Francis |